What is Laparoscopic Gastric By-Pass (R-YGB) Operation?

Laparoscopic Gastric By-Pass (R-YGB) surgery is the most frequently applied combined operation. The starting portion of the stomach is separated from the rest as to leave 30-50 cc. A part of the small intestines is by passed and connected to the newly formed small gastric pouch. Thus, the patients feel full faster with quite smaller meals. At the same time, the absorption of an important part of the high calorie nutrition is prevented.

What are the effects of Laparoscopic Gastric By-Pass (R-YGB) Operation?

Laparoscopic gastric by-pass surgery provides effective and permanent weight loss. The patients now have reduced new gastric pockets (similar to volume restriction operations) and accordingly, feel full faster with quite smaller portions of meals. However, this fast fulling is followed by frequent hunger. The patients who have undergone laparoscopic gastric by pass (R-YGB), eat smaller meals frequently. In addition, this method is applied under laparoscopic application and accordingly removes, significantly, many problems of traditional operations such as scar problems, incisional hernias and postoperative pain.

The operation has absorption-reducing effects and accordingly may cause vitamin and mineral shortages. A life long vitamin and mineral support is required.

Laparoscopic gastric by-pass surgery can be reversed if necessary. Still, before deciding for this operation, you should consult all the respective risks with your physician face to face.

The process related to procedure

Before the operation

The patients to undergo this operation shall be examined by the physician and its team, responsible for the obesity treatment of the patient, in detail. The endocrinology and psychiatry experts shall perform this evaluation on every single patient. Also, the chest diseases and cardiology consultation may be performed depending on the metabolic conditions and situations of the respective patients.

The Operation

There are many obesity surgery techniques that can be performed under laparoscopic method. Laparoscopic gastric by-pass is particularly recommended as the most effective solution in USA.  It is increasingly recommended also in Europe and Turkey.

4-6 incisions, each 1 cm, are performed in the abdominal wall of the patient and the camera with respective tools is placed. About 95% of the stomach is by passed and a part about an egg in the beginning area is left as the functional part.

Post Operation

4-6 days of hospital monitoring (staying in hospital) is required after the operation. The diet expert shall plan, before discharge from hospital, your initial feeding till the first control.  Close monitoring shall be performed in the first year by endocrinology, psychiatry and diet specialists as well as you obesity surgeon. This monitoring is required for your adaptation to your new physiology and learning the correct use of the same.

Most of the patients require plastic surgery correction operations after first two years.

For detailed information:

• 2004 ASBS Consensus Conference; Consensus Conference Statement: Bariatric surgery for morbid obesity: Health implications for patients, health professionals, and third-party payers Henry Buchwald, M.D., Ph.D., F.A.C.S. Surgery for Obesity and Related Diseases 1 (2005) 371–381
• WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. WHO technical report series 894.Geneva: World Health Organistion, 2000.
• Gastrointestinal surgery for severe obesity: National Institutes of Health Concensus Developement Conference Statement March 25-27,1991. Published: Am J Clin Nutr 1992:55:615S-9S.
• Pharmacotherapy for obesity: a quantitative analysis of four decades of published randomized clinical trials. Haddock CK et al. International Journal of Obesity (2002) 26, 262-273
• The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis Daphne P Guh, Whei Zang, Nick Bansback, Zubin Amarsi, C Laird Birmingham, Aslam H Anis BMC Public Health 2009, 9:88 doi:10.1186/1471-2458-9-88